An international study has concluded that smoking and alcohol each independently increase risk of developing head and neck cancer. This study appeared in the May 16, 2007 issue of  the Journal of the National Cancer Institute.

The combination of smoking and alcohol use is believed to account for roughly 75% of all cases of head and neck cancer. Because these two exposures often occur in combination, it can be difficult to assess the independent effect of each (the effect of smoking in the absence of alcohol and vice versa). Large sample sizes are needed to address this question.

To assemble a large population in order to assess the independent effects of tobacco and alcohol on the risk of head and neck cancer, researchers combined information from 15 previously published studies. These studies included a total of 10,244 individuals with head and neck cancer and 15,227 individuals without head and neck cancer.

Among never drinkers, smoking was linked with an increased risk of head and neck cancer. Risk of head and neck cancer increased with the frequency and duration of smoking. Smoking was estimated to account for roughly 24% of cases of head and neck cancer that occur among nondrinkers.

Among never smokers, heavy alcohol consumption was linked with an increased risk of certain types of head and neck cancer. Risk was increased among people who consumed three or more drinks per day. Heavy alcohol consumption was estimated to account for roughly 7% of cases of head and neck cancer that occur among nonsmokers.

The results indicate that smoking and heavy alcohol use can each independently increase the risk of head and neck cancer. Smoking, however, appears to be more strongly linked with head and neck cancer than alcohol.

Comments: These data suggest that smoking is more important than alcohol in the development of head and neck cancers.

Reference: Hashibe M, Brennan P, Benhamou S et al. Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, and the risk of head and neck cancer: pooled analysis in the international head and neck cancer epidemiology consortium. Journal of the National Cancer Institute. 2007; 99:777-89.

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